Retrospective audit of adult patients who underwent major surgery in our institution, and
biochemical outcomes including hyponatremia, in relation to the maintenance fluid tonicity
administered peri-operatively.

Monitoring of intraoperative core temperature is essential for patient safety, reducing the
risk of perioperative hypothermia. A recently developed measuring system, SpotOn® (3M, St.
Paul, MN), measures the core temperature in a non-invasive manner. Its accuracy in patients
undergoing general surgery has not been investigated yet. The study was aimed at comparing
the accuracy of the SpotOn® in comparison with the oesophageal probe which is considered the
current standard in our care units.

The patient's position is important for ensuring patient comfort and preventing complications
after thyroidectomy. This study was carried out to determine the effects of different degrees
of head-of-bed elevation on the respiratory pattern and drainage following thyroidectomy and
to provide suggestions for evidence-based clinical practice.

The present protocol describes a randomized, open-labelled study in which either SmofKabiven
Peripheral or a hospital compounded control Parenteral Nutrition (PN) regimen will be given
to adult surgical patients for 5 consecutive days. As serum prealbumin is a well-established
surrogate efficacy parameter reflecting the patient´s nutritional status, the absolute change
of the serum prealbumin level at the day of the final study visit compared to baseline will
represent the primary efficacy parameter in the present study. In addition, other variables
will be assessed in this study, i.e., C-reactive Protein (CRP), free fatty acids, immunology
parameters, taurine, comparison of the time required for Total Parenteral Nutrition (TPN)
preparation of the two groups, the results of physical examination, vital signs, relevant
nutrition- and safety-related laboratory parameters in venous blood and urine, the results of
an Electrocardiography (ECG), and the number, severity, seriousness, clinical relevance,
relatedness and outcome of Adverse Events (AEs). The aim of the planned study is to
demonstrate that SmofKabiven Peripheral is not inferior to the comparative drug (compounded
emulsion).

The purpose of the study is to evaluate how time from hospital admission to start of surgery
influence mortality in patients with acute hip fracture. Data on patients with hip fracture
surgery will be collected from the hospital's registration system and will be analyzed
regarding age, gender, American Society of Anesthesiologists (ASA) Physical Status
Classification, type of surgery and time from admission to surgery along with data on
mortality.

Square knots are the gold standard for hand-tied surgical knots; however, they are difficult
to reproduce in deep body cavities and can inadvertently result in slipped knots. The
investigators have shown in previous work that the reversing half-hitch alternating post
(RHAP) surgical knot is a non-inferior alternative to the square surgical knot based on its
tensile strength and performance in limited working spaces. Prior to introducing RHAP knot in
routine surgical practice, it is important to objectively demonstrate similar physical
characteristics of anastomosis created using RHAP and standard square knots. This study aims
to compare the burst pressure of cadaveric porcine small bowel anastomosis constructed using
RHAP and standard square knots on a flat surface and in a simulated deep body cavity.
The investigators are conducting a prospective randomized controlled study of novice medical
students allocated to proficiency-based training in RHAP and square surgical knots. Knot
tying proficiency will be assessed using a knot-tying checklist. Number of repetitions and
time required to achieve proficiency will be tracked for each group. Once proficiency has
been achieved by participants in RHAP and square knots group, each participant will perform
two-hand sewn small bowel anastomosis using cadaveric porcine small bowel. One anastomosis
will be performed on a flat surface and the other will be formed in a simulated deep body
cavity. Burst pressure of the anastomoses will be tested using a column of water, and results
will be compared between groups. Simple descriptive statistics will be performed for both
groups. Between group comparisons of knot-tying proficiency and burst pressure will be
performed using t-test. Learning curves within each group will be analyzed using paired 1-way
ANOVA. SPSS Statistics (v. 21, IBM, New York, USA) will be used for all statistical analysis,
with significance set to p<0.05.
The investigators hypothesize that burst pressure of cadaveric porcine small bowel
anastomosis will be equivalent for anastomosis constructed using RHAP and standard square
knots.
The results of this study will provide further validity evidence in support of RHAP as
suitable alternative to the square surgical knots.

The investigators developed a bench-top knot tying simulator (KNOTI), with computer acquired
assessment. Fifteen attending surgeons and 30 first year surgical residents were recruited to
the study held at tertiary medical center during the years 2017-2018. The participants tied
eight knots in different settings (Superficial vs. Deep) and techniques (One hand vs. two
hands).

The effectiveness of the analgesic and anti-nausea prevention techniques of the investigators
justifies being evaluated regularly in order to adapt the management strategy to the
specificities of each surgical act.
A first evaluation took place in June 2016 and allowed to identify a category of patients
(partial breast surgery with or without axillary gesture) not benefiting from an ideal
algological management because justifying in 30% of the cases of a level 3 analgesic remedy
in the postoperative recovery room. This use of morphine results in a significant incidence
of postoperative nausea and prolonged recovery time before return home harmful to the
patient.
With their experience in locoregional anesthesia technique in complete breast surgery (total
mastectomy) and aware of the effectiveness of this type of anesthesia on the management of
immediate and chronic pain, the investigators have extended their indications of ALR to
partial breast surgery in ambulatory.

Interventional studies are often prospective and are specifically tailored to evaluate direct impacts of treatment or preventive measures on disease.

Observational studies are often retrospective and are used to assess potential causation in exposure-outcome relationships and therefore influence preventive methods.

Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial.

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.

Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

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